Photo/ Video Relase Authorization

Photo/Video Release Authorization

I, _________________ of _________________ _________________, _________________ _________________ (Hereinafter "Subject"), for good and valuable consideration, hereby give permission to of 537 Jones Street # 3151 San Francisco, California 94102 (Hereinafter "") and/or parties designated by to photograph myself and use such photographs in all forms of media, for any and all promotional purposes including advertising, publicity, display, audiovisual, exhibition, commercial or editorial use.
I understand that the term "photograph" as used herein encompasses both still photographs, audio recording and motion picture footage.
I further consent to the reproduction and/or authorization by to reproduce and use such photographs for use in all domestic and foreign markets.
I hereby release and any of its associates, affiliates, appointed advertising agencies and designated directors, officers, agents, employees and customers from any claims.
In signing this agreement, as a client, you are compensating and its representative delivering the service to be rendered prior to commencing the project on the scheduled appointment. The check will be due before we perform the service that is ordered.

Make check payable to: _______________________________

In the amount of: _______________________________
DATED:    ______________,_______,________.
PRINT:    _______________________________________
SIGNATURE:     _______________________________________
ADDRESS:    _________________ _________________, _________________ _________________